Per Diem Nurse Practitioner (NP) - Emergency Acute Psychiatric Service
Massachusetts General Hospital(MGH)

This is a per diem position requiring a minimum of 3 shifts per quarter.

GENERAL SUMMARY/ OVERVIEW STATEMENT:

As a member of the Acute Psychiatry Service (APS) Provider Team, the Advanced Practice Nurse will assume the role of responding clinician in the assessment and care of patients with psychiatric and substance use disorders, including diagnosis, treatment, education, and management of the patient, in particular the patient awaiting admission to a psychiatric inpatient facility. The patient may be evaluated or seen in follow-up while in the APS, the main ED or an associated observation/ boarding unit.

The APRN will collaborate with all the members of the care team including EM and APS physicians, nurses, resource specialists, social workers, case managers, administrative staff, etc. to ensure optimal care. The APRN will facilitate and coordinate the operational, administrative and collaborative efforts of the multidisciplinary team. Additionally, APRN will work closely with the addictions APRN to coordinate care and services for individual and groups of patients.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Clinical Practice

1.1 Assesses, diagnoses, and treats the patients being evaluated and/or managed by the APS for urgent and emergent conditions, related to their behavioral or substance abuse issues. Provides age appropriate care to patients across the life span.

1.2 Performs medically delegated aspects of patient care as agreed upon by nursing and medical administrators according to practice guidelines. Such as ordering and interpreting lab and diagnostic testing. Prescribes medication and orders therapeutic treatments.

1.3 Develops and assists in the development of Acute Care Plans for repeat patients.

1.4 Demonstrates critical thinking, diagnostic reasoning skills and strong clinical skills. Able to work independently with in their scope of practice.

1.5 Provides expert consultation to other nursing, physician and hospital staff in order to maximize the opportunity to provide the most appropriate treatment and maintain safety of the patient and the staff.

1.6 Is willing and able to engage with patients in all stages of readiness.

1.7 Serves as a patient and family advocate and facilitates ethical and patient-centered decision making within the care teams.

1.8 Determines level of care needs for patients and initiates referrals, transfers, and consultations as needed for behavioral health and substance abuse disorders.

2. Administrative/Business/Professional Leadership

2.1 Monitors progress and evaluates the outcomes of their clinical practice

2.2 Suggests and facilitates initiatives that may have a department or hospital-wide impact on patient care.

2.3 Serves as a role model to reflect commitment to the philosophy and vision of the MGH, and the departments of psychiatry, nursing, and emergency medicine.

3. Education

3.1 In collaboration with physician and nursing leadership, applies evidence based research findings and experiential knowledge to support and advance clinical practice by all disciplines in the care of this patient population.

3.2 Participates in the activities that contribute to the education of health care professionals including presenting and publishing.

3.3 Facilitates the educational experience of EM and psychiatric residents in working with this patient population.

4. Research/Research Utilization

4.1 Participates in and supports research activities that will positively influence in-patient care and patient care outcomes.

4.2 Participates in and facilitates quality assurance and performance improvement activities for evaluation of structure, process, and outcome criteria as it relates to clinical practice.

4.3 Is familiar with current trends in health care and their implication to the treatment of patients with behavioral health and substance use disorders. Including: appropriate pharmacologic and non -pharmacologic treatment modalities as indicated for the management and related complications.

5. Clinical Leadership

5.1 Integrates systems thinking, ethical reasoning, and problem solving in identifying interventions that facilitate quality, cost-effective patient care outcomes.

5.2 Identifies factors contributing to outcomes, such as complications, increased length of stay, and over utilization of services and actively participates in problem solving these issues, in collaboration with appropriate staff.

5.3 Facilitates patient movement through the system and efficient use of resources through intra and interdepartmental collaboration.

5.4 Analyzes clinical and non-clinical variables to anticipate patient care needs and predict responses.

5.5 Negotiates conflict to promote collaboration.

6. Professional Development

6.1 Engages in self-performance appraisal on an annual basis, identifying areas of strength as well as areas for professional and practice development.

6.2 Identifies individual learning needs and goals and develops a plan to meet them.

6.3 Maintains clinical knowledge and skills based upon current nursing and health care practices.

6.4 Maintain membership in professional nursing organizations.

6.5 Maintains the standards and educational requirements specific to the nurse practitioner role and licensure.

6.6 Maintains and updates clinical knowledge and skills based on current health care practice/research.

Provision of episodic/consultative/recurring care to the adult patients in MGH APS, ED and boarding areas, who are diagnosed with either primary or co-occurring psychiatric or substance abuse problems.

SKILLS/ABILITIES/COMPETENCIES REQUIRED:

Relying on advanced training in psychodynamics, pathophysiology, physical assessment, pharmacology, treatment intervention, addictions management, harm reduction, and relapse prevention, the APRN provides an assessment and assistance with establishing comprehensive plans that address a broad range of concerns for the patient with behavioral health and substance abuse disorders.

These include but are not limited to:

• Assessment, diagnosis and treatment of psychiatric and substance use disorder patients
• Assessment, recommendations and assistance in promoting a safe environment
• Assisting the resource specialist with facilitating appropriate discharge dispositions
• Coordinating involuntary treatment options
• Providing education/referrals
• Coordination of services between providers, including EM and APS
• Assessment of co-occurring psychiatric and substance use disorder diagnoses
• Psychopharmacological recommendations

Qualifications
LICENSES, CERTIFICATIONS, and/or REGISTRATIONS:

Current licensure as a Psychiatric Nurse Practitioner - Psychiatric Mental Health in the Commonwealth of Massachusetts,

Current federal and state controlled substance certification/registration.

EDUCATION:

Bachelor's and Master's in Nursing Required - Psychiatric Mental Health specialty in Master's Program

EXPERIENCE:

Minimum of 2 years advanced practice experience preferred in psychiatry.

Previous nursing experience required

EEO Statement
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.

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